Active NPI
Brian Bolenbaugh
- Hearing Instrument Specialist
- San Luis Obispo, CA
National Provider Identifier
1275958571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- HA2571
- Practice address
- 628 California Blvd
Suite F
San Luis Obispo, CA 93401-2542 - Phone
- (805) 544-3277
- NPI assigned
- Feb 23, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | HA2571 | CA | Primary |
Addresses
Primary practice location
628 California Blvd
Suite F
San Luis Obispo, CA 93401-2542
Mailing address
628 California Blvd
Suite F
San Luis Obispo, CA 93401-2542
Phone (805) 544-3277
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HA2571 | CA | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393113600000",
"number": "1275958571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "628 CALIFORNIA BLVD",
"address_2": "SUITE F",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012542",
"telephone_number": "805-544-3277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "628 CALIFORNIA BLVD",
"address_2": "SUITE F",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012542",
"telephone_number": "805-544-3277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLENBAUGH",
"first_name": "BRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-23",
"last_updated": "2014-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "CA",
"license": "HA2571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.